The study, the first to include cigarette-sales data from all states and to consider the impact of tobacco-control program expenditures, shows that between 1990 and 2000, cigarette sales dropped an average of 43 percent in four states with all-inclusive tobacco-control programs.

Arizona, California, Massachusetts, and Oregon spend twice as much on their tobacco-control programs as other states, the study showed. The increased spending resulted in greater and faster declines in sales in these four states.

"It appears that sustained, well-funded programs become increasingly efficient over time," said Dr. Matthew Farrelly of the Research Triangle Institute and lead author of the study. "As states build core capacity for tobacco control, they make better and better use of each additional dollar."

The CDC defines effective state-based tobacco-control programs as those that include some or all of the following components: community and school programs and policies; counter-marketing campaigns; cessation programs, including telephone quitlines; program monitoring and evaluation; and staffing and management.

The study is published in the September 2003 Journal of Health Economics. A copy of the article, "The Impact of Tobacco Control Program Expenditures on Aggregate Cigarette Sales: 1981-2000," can be requested by e-mail or by calling the CDC's Office on Smoking and Health at 770-488-5493.

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